If your hip pain has just occurred, particularly after a fall or some other trauma, if you can’t put weight on your leg because of pain then you might have a fracture of your femur (hip bone) and need to be assessed as soon as possible. Here we will discuss long-standing pain in the hip area.

Pain in the hip is usually felt when weight-bearing, standing, walking, running. If you have suddenly developed hip pain at rest where you’re having chills and fever, you may have an infection in your hip and you should be assessed shortly.

Often pain in the hip radiates down the leg to the knee.

What Are the Usual Causes of Hip Pain?

Arthritis is probably the commonest cause of ongoing pain in the hip. If you look in the osteoarthritis section, it explains the reasons people develop arthritis and what can be done.
Trochanteric bursitis causes inflammation of the bursa overlying the greater trochanter, the bone that sticks out over the outside of the hip joint. That bursa is squeezed between the greater trochanter and the gluteus maximus muscle which attaches on the femur.
Tendonitis can occur in any of the tendons that surround the hip joint. A large number of muscles surround the hip joint and many of them attach on the greater trochanter: the gluteus minimus and medius, the pyriformis, the obturator internus and externus. Tendinitis of one or more of these muscles can give you exactly the same symptoms as trochanteric bursitis: pain when you lie on your affected side at night as well as when you are walking. A groin pull is a tendinitis of the muscles which pull your leg in, the adductor muscles. These muscles have ligaments that attach on or near the pubis and their distal ligaments attach on the femur and the upper tibia. Arthritis, trochanteric bursitis and tendinitis all have a similar cause: excessive strain on the hip joint and its supporting ligaments and tendons. This strain may be due to faulty alignment of the leg, overuse, overweight, and age.
Back and spine problems can cause symptoms around the buttocks and hip. Common problems that refer pain to the hip region are sacroiliac subluxation, herniated discs and sciatica. See back pain and sacroiliac joint. Women who are pregnant or have just given birth may experience weakness in their symphysis pubis which is a fibrous joint where the iliac bones meet as a result of relaxin, a pregnancy hormone which makes ligaments and tendons looser and the pelvis expandable in order to facilitate the baby’s birth. Because the pelvis is unstable, they have a waddling gait and they may experience a great deal of pain in the area of the pubis.
The nerves which supply the skin around the hips can, if injured, swell. These nerves, also supply the hip joint and ligaments as well as the tendons which move the leg. When these structures are injured, the nerves, which supply them, swell. The swelling traps them in the tiny holes through the fascia, the fibrous covering of the muscles through which they must pass to get to the skin. Once trapped, they cannot “slim down” as they keep re-injuring themselves on the walls of these holes, and this swelling can cause constant pain. This pain can gradually spread down the legs to the knees and even to the ankles. Pain due to loose ligaments or tendons or arthritis only comes when you move the ligaments or tendons or the joints. Nerve pain, on the other hand, can be severe and happen at any time even when you are not moving at all. If you press lightly on an area with nerve pain, the pain gets worse. The best painful hip area nerve pain treatment is perineural injection therapy (nerve blocks ).

Hip Pain Treatments

Treatment depends entirely on the cause of the problem. If you are not sure of the cause of your pain, consult with your physician. The first thing you can do is to put less stress on your joints. You can lose weight and eat foods which will help keep your joints healthy. These foods will also help you repair your ligaments and tendons and regrow your cartilage. Caveman diet
Orthotics: these shoe inserts can help straighten out the joints of your feet, knees, hips, pelvis and back and keep them tracking straight. Dr. Bertrand can provide you with a good pair of orthotics. If you have too much pain, you may need to use a cane or a walker which will unload the hip.

Heat: Hot pads may relieve pain.
Exercise, especially low impact exercise can help strengthen the muscles and potentially stimulate cartilage growth. To find out which exercises would be best, you may want to consult a physiotherapist. Unfortunately, exercise cannot rebuild an arthritic joint.

Prolotherapy, for arthritis and tendonitis of the hip

a series of injections of growth promoting substances in and around the joint has been shown to be effective in osteoarthritis of the fingers, the elbows, the knees and the back. It has been shown to stimulate the growth of ligaments, including the knee’s ACL, and tendons as well as cartilage. You can make cartilage 65% thicker with prolotherapy. Even the knee’s meniscus has been shown on ultrasound to regrow with prolotherapy. There have, however, not been any well-controlled studies of prolotherapy of the hip. In a hip prolotherapy treatment, the inside of the hip joint is injected to help regrow the hip cartilage, together with the three main ligaments which stabilize the joint: the ischio femoral, the illio femoral, and the pubo femoral ligaments. The ligaments on the greater trochanter of the groin are injected as needed.
A study of 24 rugby and soccer players suffering from groin pull and unable to play for an average of 15 1/2 months treated with 2 to 6 injection sessions of prolotherapy at monthly intervals. 6 to 32 months later 22 of the 24 where back playing full-time.

Topol GA, Reeves KD and Hassanein, KM Efficacy of dextrose prolotherapy in elite male kicking sports athletes with groin pain Arch Phys Rehabil 86, 697-702

For an unstable symphysis pubis, surgery has produced very poor results. Because prolotherapy helps regrow ligaments and tendons it may prove more effective, but no studies have yet been done.
Chondroitin and glucosamine sulfate, are natural substances found in the joint fluid. Chondroitin is thought to promote an increase in the making of the building blocks of cartilage (collagen and proteoglycans) as well as having an anti-inflammatory effect (In the end, this decreased inflammation may prove counterproductive). Glucosamine may also stimulate production of the building blocks of cartilage as well as being an anti-inflammation agent. A recent study showed that glucosamine slowed progression of osteoarthritis in the knee. Glucosamine was found to increase blood sugar in animal studies, so people with diabetes should consult their doctor first.
Acetaminophen, Tylenol, which is a COX3 inhibitor, has a mild anti-inflammatory effect. It, and the NSAIDs aspirin, ibuprofen, Advil, Motrin, diclofenac, Voltaren, have, until now, been the mainstay of treatment to relieve arthritis pain. They all relieve the symptoms that occur with overstretched and worn ligaments and tendons. They work by stopping inflammation which is a cause of pain through inhibiting the enzyme cyclooxygenase (COX) which promotes the formation of inflammatory substances. Unfortunately, inflammation is the mechanism the body uses to repair itself, and using these medications interferes with the process which would help regrow the affected ligaments and tendons. All NSAIDs can cause bleeding of the stomach, high blood pressure, and kidney failure, and the COX 2 inhibitors, such as Celebrex, also increase the risk of heart attacks. Anti-Inflammatory References Narcotics have been given to people with severe arthritis pain who, because of liver or kidney failure could not tolerate acetaminophen or NSAIDs.
People who have suffered from intractable arthritis pain are often given cortisone shots in the joints. These, being even more powerful anti-inflammatory substances, unfortunately interfere with healing even more than other anti-inflammatory medications and may even be associated with cartilage destruction. It is also easy for a joint that has been injected with steroids to get infected as steroids block the inflammatory response which helps your body fight infection. Infection in a joint can totally destroy the joint. Cortisone shots are very effective in treating trochanteric bursitis where they often provide pain relief for several months.